Endoscopic system for enhanced visualization

ABSTRACT

A medical device, configured for insertion into a body, may include an elongate member extending from a proximal end to a distal end, where the distal end may be configured to be positioned inside the body. The medical device may also include an imaging device positioned at the distal end. The medical device may further include a plurality of light sources positioned at the distal end, wherein a characteristic of light delivered through a first light source may be controlled independent of the characteristic of light delivered through a second light source.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is based upon and claims the benefit of priority under35 U.S.C. § 119(e) of U.S. Provisional Application No. 61/372,114 toBenning et al. filed on Aug. 10, 2010.

FIELD OF THE INVENTION

Embodiments of the present invention relate to an endoscopic system. Inparticular, exemplary embodiments of the present invention relate toendoscopes for enhanced visualization. Embodiments of the presentinvention also cover methods of using such devices.

BACKGROUND OF THE INVENTION

An endoscope is a flexible instrument introduced into the body fordiagnostic or therapeutic purposes. Typically, these devices areinserted into the body through an opening (a natural opening or anincision), and are delivered to a work site inside the body through abody channel, such as, for example, the esophagus. Imaging devicesincorporated in the endoscope allows a surgeon to see the work site fromoutside the body and remotely operate the endoscope to perform a desireddiagnostic/therapeutic procedure at the work site. There are manydifferent types of endoscopes in use today and embodiments of thecurrent disclosure may be applied with any of these different types ofendoscopes. In general, embodiments of the current disclosure may beapplicable with any type of medical device that can be inserted into abody, and that allows a surgeon outside the body to visualize a regioninside the body. For the sake of brevity, however, the novel aspects ofthe current disclosure will be described with reference to an endoscope.

In a typical application, a distal end of an endoscope may be insertedinto the body through an opening in the body. This opening may be anatural anatomic opening, such as, for example, the mouth, rectum,vagina, etc., or an incision made on the body. The endoscope may bepushed into the body such that the distal end of the endoscope proceedsfrom the point of insertion to a region of interest (work site) withinthe body by traversing a body channel. The endoscope may include one ormore lumens extending longitudinally from the proximal end to the distalend of the endoscope. These lumens may deliver variousdiagnostic/treatment devices to the work site to assist in theperformance of the intended procedure at the work site.

Among others, these lumens may include an illumination lumen thatincludes an illumination source to illuminate a field of view at thework site, and an imaging lumen that includes an imaging device tocapture an image of the work site and deliver the image outside thebody. A diffusing lens may be used to attempt to project light evenlyover the entire visualization field through the illumination lumen. Dueto the differences in proximities, and other light reflectingcharacteristics of different locations within the field of view of thework site (such as, for example, differences in reflectivity of muscleand tissue), these different locations may appear to be illuminateddifferently. For instance, some of these locations may appear to beoversaturated with light while other locations may appear to beinsufficiently illuminated. This variation in illumination may makevisualization of the work site difficult, and may therefore beundesirable. An endoscope with a diffusing lens may, however, be limitedto providing uniform light across the entire field of view.Additionally, with small bore endoscopes, the cost of implementing adiffusing lens for even distribution of light may be high. While thiscost may be less of an issue with reusable endoscopes where the cost canbe amortized due to repeated usage, this cost may be prohibitively highin the case of disposable endoscopes. The current disclosure is directedto systems and methods configured to enable clear visualization of afield of view within the body from outside the body.

SUMMARY OF THE INVENTION

An embodiment of the invention includes a medical device configured forinsertion into a body. The medical device may include an elongate memberextending from a proximal end to a distal end, where the distal end maybe configured to be positioned inside the body. The medical device mayalso include an imaging device positioned at the distal end. The medicaldevice may further include a plurality of light sources positioned atthe distal end, wherein a characteristic of light delivered through afirst light source may be controlled independent of the characteristicof light delivered through a second light source.

Various embodiments of the invention may include one or more of thefollowing aspects: the plurality of light sources may include aplurality of fiber optic cables that terminate at the distal end; theplurality of light sources may include at least one LED; each of theplurality of light sources may be positioned at different locations atthe distal end; the plurality of light sources may be configured to beilluminated by a common illumination source positioned outside the body;the characteristic of light may include at least one of an intensity, awavelength, a polarization, a frequency, or a phase of light; themedical device may also include an illumination control system that isconfigured to vary the characteristic of light directed through thefirst light source independent of the characteristic of light directedthrough the second light source; the illumination control system mayinclude controls that enable a user to manually vary the characteristicof light directed through the first light source independent of thecharacteristic of light directed through the second light source; theillumination control system may include an algorithm configured toautomatically vary the characteristic of light directed through thefirst light source independent of the characteristic of light directedthrough the second light source; the algorithm may automatically varythe characteristic of light directed through the first light sourceindependent of the characteristic of light directed through the secondlight source based on an illumination of an image captured by theimaging device; the medical device may also include an illuminationcontrol system that is configured to vary the characteristic of lightbased on input from one or more light sensors; and the medical devicemay be an endoscope.

An embodiment of the invention may also include a method of using amedical device. The method may include inserting a distal end of themedical device into a body. The medical device may extend from thedistal end to a proximal end, and may include at least an imaging deviceand a plurality of light sources positioned at the distal end. Themethod may also include positioning the distal end proximate a work sitewithin the body, and activating the imaging device to receive an imageof the work site outside the body. The method may further includeadjusting a characteristic of light directed through one of the lightsources independent of the characteristic of light directed throughother of the light sources based on the received image.

Various embodiments of the invention may include one or more of thefollowing aspects: adjusting the characteristic of light may includevarying an intensity of light directed through one of the light sourcesindependent of the intensity of light directed through the other of thelight sources; adjusting the characteristic of light may includemanually adjusting the characteristic of light directed through one ofthe light sources independent of the characteristic of light directedthrough the other of the light sources; adjusting the characteristic oflight may include automatically adjusting the characteristic of lightdirected through one of the light sources independent of thecharacteristic of light directed through the other of the light sourcesbased on an illumination of the received image; and the characteristicof light may include at least one of an intensity, a wavelength, apolarization, a frequency, or a phase of light.

An embodiment of the invention may further include an endoscope. Theendoscope may include an elongate body extending from a proximal end toa distal end, and an imaging device positioned at the distal end. Theimaging device may be configured to direct an image of a work siteproximate the distal end to a viewing device positioned proximate theproximal end. The endoscope may also include a plurality of lightsources positioned at the distal end. The plurality of light sources maybe configured to illuminate the work site. The endoscope may alsoinclude an illumination control system configured to vary acharacteristic of light directed through one of the light sourcesindependent of the characteristic of light directed through other of thelight sources based on an illumination of the image on the viewingdevice.

Various embodiments of the invention may include one or more of thefollowing aspects: the characteristic of light may include at least oneof an intensity, a wavelength, a polarization, a frequency, or a phaseof light; the plurality of light sources may include at least threelight sources and the illumination control system may be configured tovary a characteristic of light directed through each one of the threelight sources independent of the characteristic of light directedthrough the other two light sources; the illumination control system maybe configured to automatically vary a characteristic of light directedthrough one of the light sources independent of the characteristic oflight directed through the other of the light sources based on theillumination of the image; the plurality of light sources may include aplurality of fiber optic cables that terminate at the distal end, theplurality of light sources may be configured to be illuminated by acommon illumination source positioned proximate the proximal end of theelongate body.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated in and constitute apart of this specification, illustrate embodiments of the invention andtogether with the description, serve to explain the principles of theinvention.

FIG. 1 is a schematic view of an embodiment of an endoscope performingan exemplary endoscopic procedure.

FIG. 2A is an illustration of the distal end of the endoscope of FIG. 1.

FIG. 2B is an illustration of the proximal end of the endoscope of FIG.1;

FIG. 3 is an illustration of illumination coverage at a work site usingthe endoscope of FIG. 1; and

FIGS. 4A-4C are illustrations of different embodiments of the distal endof endoscopes of the current disclosure.

DESCRIPTION OF THE EMBODIMENTS

Reference will now be made to exemplary embodiments of the invention,examples of which are illustrated in the accompanying drawings. Whereverpossible, the same reference numbers will be used throughout thedrawings to refer to the same or like parts.

The terms “proximal” and “distal” are used herein to refer to therelative positions of the exemplary endoscopic device 20. When usedherein, “proximal” refers to a position relatively closer to theexterior of the body or closer to the surgeon using the endoscopicdevice 20. In contrast, “distal” refers to a position relatively furtheraway from the surgeon using the endoscopic device 20 or closer to theinterior of the body.

FIG. 1 depicts an exemplary endoscopic device 20 performing an exemplarymedical procedure on a patient. Endoscopic device 20 may be insertedinto stomach 12 through the esophagus 14, and positioned in stomach 12such that a distal end 22 of endoscopic device 20 may be positionedproximate a work site 18 on stomach wall 16. A proximal end 28 (see FIG.2B) of endoscopic device 20 may extend out of the body of the patientand may be controlled to perform the desired operations at the distalend 22 of the endoscopic device 20. It should be emphasized that themedical procedure illustrated in FIG. 1 is exemplary only, and thatendoscopes of the current disclosure may be applied to any endoscopicapplication known in the art. It should also be emphasized thatendoscopic device 20 of FIG. 1 can be any medical device that can beused to visualize a region inside the body from outside the body. Forexample, endoscopic device 20 of FIG. 1 may include any type of imagingendoscopes, guide tubes, catheters or the like without limitation.

Endoscopic device 20 may include a flexible elongate member 26 extendingbetween the proximal end 28 and distal end 22. During use, distal end 22may be positioned proximate work site 18 within a body and the proximalend 28 may be positioned outside the body. Elongate member 26 may beflexible so as to enable endoscopic device 20 to bend and pass throughtortuous body passages as distal end 22 of endoscopic device 20 advancesto work site 18. In some embodiments, elongate member 26 may be made of,or coated with, a polymeric or a lubricious material to enable theendoscopic device 20 to pass through body cavities with ease.

FIGS. 2A and 2B are schematic illustrations of distal end 22 andproximal end 28, respectively, of endoscopic device 20. In thediscussion that follows, reference will be made to both FIGS. 2A and 2B.Endoscopic device 20 may include one or more lumens 34 a, 34 b, 34 c,etc. extending therethrough and terminating at distal end 22. Theselumens may be configured to direct tools/instruments and the like towork site 18 from outside the body. Although these lumens areillustrated as being circular, in general, the lumens can have anycross-sectional shape. Distal end 22 of endoscopic device 20 may alsoinclude devices (36, 38) that are embedded or attached thereon. Thesedevices may be configured to perform tasks to assist in the medicalprocedure at work site 18. Although not illustrated in FIG. 2A, distalend 22 of endoscopic device 20 may also include one or more endeffectors that are configured to perform specific tasks at work site 18.These end effectors may be coupled to a distal end of an endoscopicdevice and may be operatively coupled to, and controlled by, anactuation device 46 (i.e. a handle) at the proximal end 28 of endoscopicdevice 20 (see FIG. 2B).

One or more of the lumens 34 a, 34 b, 34 c may extend from distal end 22to proximal end 28 longitudinally along elongate member 26. These lumensmay have a constant cross-sectional shape along the entire length ofelongate member 26 or may have a cross-sectional shape that changesalong the length of elongate member 26. This change in cross-sectionalshape along the length may be step wise or gradual. In some embodiments,some or all lumens may be lined with a polymeric or another layer orcoating to facilitate use. The lumens 34 a, 34 b, 34 c may provideaccess to instruments and facilities that may aid in performing desiredmedical procedures at work site 18. These lumens may include one or moreof, among others, an irrigation lumen 34 a, an aspiration lumen 34 b,and a working lumen 34 c.

The irrigation lumen 34 a may be configured to facilitate fluid flowfrom proximal end 28 to distal end 22. In some embodiments, theirrigation lumen may be attached to a source of fluid at proximal end 28and to a nozzle (or other similar device that is configured to alterfluid flow) at distal end 22. Aspiration lumen 34 b may be configured tofacilitate suction and/or fluid flow through it. In some embodiments,fluid may be directed from proximal end 28 to distal end 22 throughirrigation lumen 34 a to clean work site 18. Suction may then be appliedat proximal end 28 of aspiration lumen 34 b to remove the fluid (and/orbiological material) from work site 18 through the aspiration lumen. Inthis manner, a tissue sample may be extracted out of the body throughaspiration lumen 34 b.

The working lumen 34 c may include a conduit that is configured todeliver an endoscopic instrument or device to work site 18. Theendoscopic instrument may include any tool that is configured to performa desired function at work site 18 while being remotely controlled byactuation device 46 from outside the body. The endoscopic instrument maybe configured as an end effector attached at the distal end of anendoscopic instrument. For instance, the endoscopic instrument mayinclude surgical forceps attached at the distal end of links that may bemanipulated from the proximal end by actuation device 46 to control theoperation of the forceps at work site 18. In general, working lumen 34 cmay have any suitable shape, size, and configuration that is configuredto pass the end effector therethrough. Although only one working lumen34 c is illustrated in FIG. 2A, in some embodiments, endoscopic device20 may include multiple working lumens configured to direct a pluralityof surgical tools to work site 18.

The devices on distal end 22 of endoscopic device 20 may include animaging device 36 and an illumination device 38. Imaging device 36 mayinclude a camera, imaging sensor (such as, for example, a complimentarymetal-oxide semiconductor or a CMOS sensor), a light sensor, or anotherimage receiving device (such as, for example, a fiber optic imagingdevice). Imaging device 36 may transmit an image signal to a monitor orother display device 42 positioned outside the body and viewable by thesurgeon. The image signals may correspond to still pictures and/ortransient images that display time varying images of work site 18 on thedisplay device 42. In some embodiments, image sensor 36 may transmit theimage signals to the display device 42 wirelessly, while in otherembodiments imaging device 36 may transmit the signals using wire or acable (fiber optic or another type of cable) embedded along the lengthof the elongate member 26. In some embodiments, image signals fromimaging device 36 may be processed by a control device 40 before beingdirected to display device 42. It is also contemplated that, in somedevices, control device 40 may also direct a control signal to imagingdevice 36 to control various aspects of its operation. In someembodiments, in addition to, or in place of imaging device 36 fixed todistal end 22, an imaging device may be delivered to distal end 22through a working lumen of endoscopic device 20.

Illumination device 38 may include any device that is configured toilluminate work site 18. Illumination device 38 may include, amongothers, bulbs, LEDs, one or more fiber optic cables, and light guides.In one embodiment, the illumination device may include a plurality offiber optic cables. Other embodiments may include a collection of one ormore other types of light sources. In the embodiment illustrated in FIG.2A, illumination device 38 is depicted as a cluster comprising fourindividual fiber optic cables 38 a, 38 b, 38 c, and 38 d. However, otherembodiments may include a different number of fiber optic cables and adifferent positioning of the fiber optic cables (discussed withreference to FIGS. 4A-4C). These fiber optic cables 38 a, 38 b, 38 c,and 38 d may direct light to distal end 22 from an external light sourceat proximal end 28 to illuminate work site 18.

The external light source may include one or more LED, Xenon, or otherlight sources in an illumination control system 50. Illumination controlsystem 50 may be configured to control and vary a characteristic of thelight directed to each of the fiber optic cables individually. Thischaracteristic may include intensity, wavelength, polarization,frequency, phase or any other characteristic that can vary the level ofillumination directed through each of the individual fiber optic cables.That is, in one embodiment, illumination control system 50 may beconfigured to set the intensity of light directed to fiber optic cable38 a at a first level, the intensity of light directed to fiber opticcable 38 b at a second level different from the first level, theintensity of light directed to fiber optic cable 38 c at a third leveldifferent from the first and second levels, and the intensity of lightdirected to fiber optic cable 38 d at a fourth level different from thefirst, second, and third levels.

Illumination control system 50 may also include one or more lightsources, control electronics, and associated control algorithms thatoperate cooperatively to modulate the amount of light directed to eachof the individual fiber optic cables 38 a, 38 b, 38 c, and 38 d. In oneembodiment, illumination control system 50 may include a single lightsource with individual lenses, irises, and/or filters to modulate theamount of light directed to each of the individual fiber optic cables 38a, 38 b, 38 c, and 38 d. Any optical arrangement known in the art may beused to split the light from the single light source into multiple beamshaving different characteristics and direct each beam through theindividual fiber optic cables 38 a, 38 b, 38 c, and 38 d. In otherembodiments, illumination control system 50 may include multiple lightsources to vary the characteristic of light input to the individualfiber optic cables 38 a, 38 b, 38 c, and 38 d. In applications involvingdisposable endoscopes, illumination control system 50 may form thecapital equipment that may be used along with a disposable endoscope.Since the illumination control system 50 may be reused with differentdisposable endoscopes, the sensitivity of cost of the illuminationcontrol system 50 to the application may be low.

FIG. 3 illustrates an exemplary illumination coverage in work site 18 inan embodiment using four individual fiber optic cables. First region 48a may be the area illuminated by fiber optic cable 38 a, second region48 b may be the area illuminated by fiber optic cable 38 b, third region48 c may be the area illuminated by fiber optic cable 38 c, and fourthregion 48 d may be the area illuminated by fiber optic cable 38 d. Theregions of overlap may be illuminated by multiple fiber optic cables andmay naturally be areas of relatively high illumination. In someembodiments, distal end 22 of endoscopic device 20 may be manipulated toposition an area of interest of work site 18 at a region of maximumoverlap 58. Based on an image in display device 42, the surgeon maydetermine that some of the regions should be illuminated differentlyfrom other regions for good visualization of work site 18. Illuminationcontrol system 50 may include controls 52 (such as, for example,controls 52 a-52 f) to selectively vary the level of illumination in thedifferent regions, including regions of overlap that are illuminated bymultiple fiber optic cables. For instance, if an image in display device42 indicates that the level of illumination in the first region 48 a istoo low and the level of illumination in the second region 48 b is toohigh, the surgeon may manipulate the controls 52 of illumination controlsystem 50 to increase the illumination level of first region 48 a anddecrease the illumination level of second region 48 b.

In some embodiments, the endoscopic device 20 may include a plurality ofpreset illumination patterns. These preset illumination patterns maycorrespond to illumination patterns where the intensity (or anothercharacteristic) of light through each fiber optic cable 38 a-38 d may beoptimized for a certain application or for a certain location in thebody. For example, one preset pattern may correspond to an illuminationpattern that is optimized for a particular endoscopic procedure (suchas, for example, hemostasis of a bleeding ulcer) and another presetpattern may correspond to an illumination pattern that is optimized foranother endoscopic procedure or a particular location within the body(such as, for example, the esophagus). In some embodiments, some of thepreset illumination patterns may be configured to change over time. Forinstance, an illumination pattern may change as the distal end 22 of theendoscopic device 20 traverses a body tract for optimal visibility ofdifferent sections of the body tract. These preset illumination patternsmay be selected by a user, for example, by activating a control ofillumination control system 50. The preset illumination patterns may bepreset by a supplier or a user, and may be adapted to be modified asdesired.

In some embodiments, illumination control system 50 may include acontrol algorithm to adjust the illumination of the work siteautomatically. This control algorithm may include software codes thatanalyze the image from imaging device 36 and automatically control theintensity of light in each of the fiber optic cables for optimalillumination of work site 18. For instance, analysis of a captured imagefrom imaging device 36 may indicate that the first region 48 a isrelatively dark and the second region 48 b is relatively bright ascompared to the other regions. Illumination control system 50 mayautomatically vary the intensity of light directed to each of theindividual fiber optic cables in steps until a subsequent image analysisindicates that the differences in illumination of different regions iswithin an acceptable threshold. In some embodiments, the illuminationcontrol system 50 may be configured to “learn” from each illuminationadjustment operation and improve over time. In one such embodiment, theillumination control system 50 may include a self-learning neuralnetwork or another similar algorithm. The neural network may include atraining mode and a usage mode. In the training mode, illuminationcontrol system 50 may be trained to output a selected pattern of lightthrough each fiber optic cable for a particular image pattern on imagingdevice 36. In the usage mode, when this image pattern is detected inimaging device 36, the illumination control system 50 may output theselected pattern of light through the fiber optic cables. If an imagepattern on imaging device 36 does not belong to a taught list of imagepatterns, a characteristic of light through each fiber optic cable maybe manually or automatically adjusted for optimal illumination of worksite 18, and the output pattern of light may be added to the taught listof image patterns.

FIGS. 4A through 4C illustrate the distal end 22 of differentembodiments of endoscopic devices of the current disclosure. Inendoscopic device 20A of FIG. 4A, four fiber optic cables 38 a, 38 b, 38c, and 38 d are positioned at spaced locations on distal end 22. Inendoscopic device 20B of FIG. 4B, six fiber optic cables 38 a, 38 b, 38c, 38 d, 38 e, and 38 f are positioned at spaced locations on distal end22. In endoscopic device 20C of FIG. 4C, four clusters of fiber opticcables, each cluster including four fiber optic cables, are positionedat spaced locations on distal end 22. The positioning of the fiber opticcables in FIGS. 4A-4C is only exemplary. In general, the fiber opticcables (38 a, 38 b, etc.) may be positioned at any location on distalend 22 of endoscopic device 20. In some embodiments, the fiber opticcables (38, 38 b, etc.) may be positioned symmetrically about a centerpoint of distal end 22 while in other embodiments they be positionedasymmetrically depending on the application, for example. In each ofthese embodiments, a characteristic of the light emitted by some or allof the individual fiber optic cables may be individually varied byillumination control system 50. For instance, in the embodiments ofFIGS. 4A and 4B, the intensity of the light emitted by each of theindividual fiber optic cables (38 a, 38 b, 38 c, and 38 d in theembodiment of FIG. 4A and 38 a, 38 b, 38 c, 38 d, 38 e, and 38 f in theembodiment of FIG. 4B) may be varied individually by illuminationcontrol system 50. And, in the embodiment of FIG. 4C, the intensity oflight emitted by each cluster of fiber optic cables (38 a-38 d, 38 e-38h, 38 i-38 l, and 38 m-38 p) may be varied individually.

Any type of fiber optic cable (plastic, glass, etc.) may be used asillumination device 38. Although in the description above, the intensityof light directed through each fiber optic cable is described as beingvaried, in general, any characteristic of light that can modulate theillumination at distal end 22 may be varied by illumination controlsystem 50. For instance, in some embodiments, the characteristic oflight that is varied by the illumination control system 50 may include awavelength of the light directed through each fiber optic cable.Additionally, although illumination device 38 is described as being afiber optic cable, this is not a limitation. In general, anyillumination device that is capable of being individually controlled maybe used as illumination device 38. For instance, in some embodiments,LEDs may be used as illumination device 38. In these embodiments,illumination control system 50 may control each LED individually tocontrol a characteristic of the light emitted by each individual LED. Inother embodiments, combinations of different illumination devices may beused.

In some embodiments, the illumination devices 38 at distal end 22 ofendoscopic device 20 may be operatively coupled with one or moreadjustable diffusing lenses or other adjustable lens membranes toselectively vary a characteristic of light emitted by each illuminationdevice 38. In these embodiments, a characteristic of the light emittedby each illumination device 38 may be changed by selectively activatingthe diffusing lens or lens membrane associated with that illuminationdevice. The diffusing lens or lens membrane may be selectively activatedby any means, such as, for example, a pressure may be applied to thelens membrane to change its optical properties, and therefore, acharacteristic of light passing through the membrane. A pressure may beapplied to the lens membrane by applying an electric current to themembrane.

In some embodiments, the lenses may be independently controlled to aimlight at or away from a particular point, direct, focus, obscure, and/orchange a characteristic of (for example, frequency, etc.) of the light.In some embodiments, a lens or another optical member associated with anillumination device may be biased to provide more (or less) illuminationto a region of work site 18 illuminated by that illumination device. Insome embodiments, the illumination control system 50 may vary a cant ortilt of a fiber optic cable (or another illumination device) relative toa longitudinal axis of the endoscopic device 20 to vary a characteristicof light delivered to work site 18 through that cable. The cant of thefiber optic cable may be changed by advancing or retracting wedges orother positioning mechanisms associated with that cable. In someembodiments, combinations of light sources (such as, for example, LEDand fiber optic) may be used to provide illumination. In some suchembodiments, different combinations of these light sources may be usedto vary the level of illumination directed at a particular region. Insome embodiments, one or more light sensors could be used in additionto, or as, cameras. These light sensors may assist in automatically ormanually adjusting the illumination effect.

The embodiments described herein are exemplary only, and it will beapparent to those skilled in the art that various modifications andvariations can be made in the disclosed systems and processes withoutdeparting from the scope of the invention. Other embodiments of theinvention will be apparent to those skilled in the art fromconsideration of the specification and practice of the inventiondisclosed herein. It is intended that the specification and examples beconsidered as exemplary only, with a true scope of the invention beingindicated by the following claims.

1.-22. (canceled)
 23. A medical device, comprising: an imaging deviceconfigured to detect an image from inside a body; a plurality of lightsources configured to illuminate different regions within the body; anda control device having a processor configured to execute instructionsthat control the plurality of light sources by: determining, based onthe image detected by the imaging device, an illumination of a firstregion within the body by a first light source; determining, based onthe image detected by the imaging device, an illumination of a secondregion within the body by a second light source; using a threshold todetermine whether to vary a first characteristic of light output by thefirst light source to enhance illumination of the first regionindependent of a second characteristic of light output by the secondlight source to enhance illumination of the second region; and varyingthe first characteristic of light based on the threshold to change theillumination of the first region.
 24. The medical device of claim 23,wherein the imaging device is positioned inside the body, and includes acamera, a CMOS sensor, a light sensor, or a fiber optic imaging device.25. The medical device of claim 23, wherein the plurality of lightsources includes a fiber optic cable or a light-emitting diode (LED).26. The medical device of claim 23, wherein the first characteristic oflight from the first light source includes at least one of an intensity,a wavelength, a polarization, a frequency, or a phase of light.
 27. Themedical device of claim 23, further including an adjustable lensconfigured to vary the first characteristic of light from the firstlight source, the adjustable lens being adjustable in response to apressure change to the adjustable lens in response to an electriccurrent applied to the adjustable lens.
 28. The medical device of claim23, wherein the control device is configured to execute instructionsthat control the plurality of light sources by: comparing a differencein illumination between the first region and the second region to thethreshold; and varying the first characteristic of light output by thefirst light source independent of the second characteristic of lightoutput by the second light source to minimize the difference inillumination between the first region and the second region.
 29. Themedical device of claim 28, wherein the control device is configured toautomatically determine differences in illumination between the firstregion, the second region, and a plurality of remaining regions insidethe body as the plurality of light sources traverse through the body.30. The medical device of claim 29, wherein the control device isconfigured to automatically vary the first characteristic of lightoutput by the first light source, the second characteristic of lightoutput by the second light source, or a corresponding characteristic oflight output by one or more of the plurality of remaining light sourcesto optimize illumination of the different regions within the body. 31.The medical device of claim 28, wherein the control device is configuredto determine the first region is darker relative to the second regionand a plurality of remaining regions within the body based on the imagedetected by the imaging device.
 32. The medical device of claim 31,wherein the control device is configured to determine the second regionis brighter relative to the first region and the plurality of remainingregions within the body based on the image detected by the imagingdevice.
 33. The medical device of claim 32, wherein the control deviceis configured to execute instructions that control the plurality oflight sources by: increasing the first characteristic of light output bythe first light source to brighten the first region; and decreasing thesecond characteristic of light output by the second light source todarken the second region.
 34. The medical device of claim 33, whereinthe control device is configured to execute instructions that controlthe plurality of light sources by: adjusting the correspondingcharacteristic of light output by one or more of the plurality ofremaining light sources to optimize illumination of the differentregions within the body.
 35. The medical device of claim 23, wherein themedical device is an endoscope that includes a member extending from aproximal end to a distal end, the distal end is configured to bepositioned inside the body while the proximal end is positioned outsidethe body.
 36. The medical device of claim 35, wherein each of theplurality of light sources is positioned at a different location on thedistal end of the member.
 37. A medical device, comprising: an imagingdevice configured to detect an image pattern; a plurality of lightsources configured to illuminate different regions inside a body; and acontrol device having a processor configured to execute instructionsthat control the plurality of light sources by: determining anillumination of each of the different regions inside the body by theplurality of light sources based on the image detected by the imagingdevice; analyzing the illumination of each of the different regionsrelative to a threshold to determine whether to vary a characteristic oflight output by one or more of the plurality of light sources to enhancethe illumination of one or more of the corresponding regions illuminatedby the one or more of the plurality of light sources; and varying thecharacteristic of light output by one or more of the plurality of lightsources based on analyzing the threshold to change the illumination ofone or more of the corresponding regions.
 38. The medical device ofclaim 37, wherein the characteristic of light output by one or more ofthe plurality of light source includes at least one of an intensity, awavelength, a polarization, a frequency, or a phase of light.
 39. Themedical device of claim 37, wherein the control device is configured toexecute instructions that control the plurality of light sources by:comparing differences in illumination between the different regions tothe threshold; and varying at least one characteristic of light from oneor more of the plurality of light sources to maintain the differences inillumination between the different regions within the threshold.
 40. Themedical device of claim 39, wherein the control device is configured toexecute instructions that control the plurality of light sources by:determining at least one region is darker or brighter relative to theremaining regions within the body based on the image detected by theimaging device; and increasing or decreasing the correspondingcharacteristic of light illuminating the at least one region when the atleast one region is darker or brighter relative to the remaining regionswithin the body, respectively.
 41. A medical device, comprising: adevice configured to detect an image pattern; a first light source and asecond light source configured to illuminate different regions in thebody; and a control device having a processor configured to executeinstructions that: determine, based on the image detected by the imagingdevice, an illumination of a first region in the body by light output bythe first light source and an illumination of a second region in thebody by light output by the second light source; determine, based on athreshold, whether to vary at least one of a first characteristic oflight of the first light source to enhance the illumination of the firstregion and the second characteristic of light of the second light sourceto enhance the illumination of the second region; and deliver light toilluminate at least one of the first region with the first light sourceaccording to the varied first characteristic and the second region withthe second light source according to the varied second characteristic.42. The medical device of claim 41, wherein the control device isconfigured to execute instructions that: determine that the illuminationof the first region varies relative to the illumination of the secondregion by the threshold; and vary the first characteristic of the firstlight source or the second characteristic of the second light sourcewhen the illumination between the first region and the second regionexceeds the threshold.